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Sanjay Gupta MD

The End of IVF?; Outsmarting the Number One Killer of Women

Aired August 25, 2012 - 16:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

DR. SANJAY GUPTA, HOST: Hello and thanks for being with us.

Lots to get to today.

I'm going to tell you what you can learn from Rosie O'Donnell's heart attack. There are warning signs that she like millions of women overlook.

Also, the latest, incredible effort out of Diana Nyad. Swimming from Cuba to Key West, she fell short yet again, and she's going to share the inside story of what really happened.

But, first, politics and fertility treatment under the microscope.

You know, if you watched TV this week, just about every media outlet has been covering attempts to end abortion. But did you also know that some of those efforts may have major consequences for people who are looking into in vitro fertilization?

Vice presidential candidate Paul Ryan sponsored a bill called last year. It's called H.R. 212. It's a so-called Sanctity of Human Life Act. Its main objective is to provide human life deemed to begin with fertilization.

Here's the issue: some fertility doctors say this could create human complications in the way that they carry out IVF, in vitro fertilization. For example, they say they could end up charged with homicide if an embryo they create subsequently dies.

Now, we invited both Representative Ryan and Governor Romney on the program to talk about this, they declined. They didn't want to answer these questions about whether or not this is a fair concern.

I should also point out that Governor Romney has a personal stake in this whole issue. He has grandchildren who were, in fact, born through IVF and he said that he supported IVF in the past. Back in January, during the primary debate, he stated that he believes life begins at conception.

(BEGIN VIDEO CLIP)

GOV. MITT ROMNEY (R), PRESIDENTIAL CANDIDATE: I was also a governor in a state where being pro-life was not easy. And I battled hard. What came to my desk was a piece of legislation that said we're going to redefine when life begins. In our state, we said life began at conception. The legislature wanted to change that, to say, no, we are going to do it an implantation. I vetoed that.

(END VIDEO CLIP)

GUPTA: You know, we really wanted to hear both sides of this. So, we invited on the GOP Doctors Caucus, the Congressional Pro-Life Caucus and also the 53 other sponsors of the Sanctity of Human Life Act. For several days, we tried to reach out. They all either said "no thanks," no reply, or it seems no one wants to talk on camera. They didn't even provide a statement.

So, joining us now is one of the doctors who is concerned about this, lives in the real world, Dr. Daniel Shapiro. He's medical director of the Reproductive Biology Associates.

Thanks for joining us.

DR. DANIEL SHAPIRO, REPRODUCTIVE BIOLOGY ASSOCIATES: Thanks for having me.

GUPTA: I was telling you beforehand, every time this topic has come up, even within our unit here at CNN, it leads to these big discussions. People obviously have a lot to say about this. The bill -- and I've read it and you have read it as well -- it doesn't specifically mention in vitro fertilization. It doesn't say it outlaws in vitro fertilization. So, that part of it is not true.

What is your concern specifically?

SHAPIRO: The biggest problem is these are under a category that we call personhood bills that basically establish human life begins at conception. The problem with all of that is that in a typical in vitro cycle, there's more than one embryo created. And if you're being safe and cautious, you only put one embryo, at most two back into a patient at a time.

So what happens to all the leftover embryos? Many of them are frozen and many of them are never used. So these bills basically would make us the guardians potentially of all these embryos and would restrict how they can be handled. That some of the restrictions would also make the IVF very inefficient for these patients, because frankly, the overwhelming majority of embryos created in our labs are not capable of actually making a whole baby.

GUPTA: So from your perspective -- let's say there was an initiative and this passed and was actually part of law in this country -- what could happen to you if something happened to one of the embryos, they didn't survive?

SHAPIRO: Well, at one extreme, we could be accused of homicide if -- or negligent homicide, because we're not taking care of an embryo. At the more reasonable level, I think we could be considered negligent, in general. But patients, we know from experience when these kinds of bills were introduced here in Georgia, patients actually rose up in mass numbers to fight it because they understood, even if they were people of faith, they understood that this interfered with their ability to family build, and that IVF is not an efficient process and that part of the process is that certain embryos will not be used and will likely be discarded.

GUPTA: What do you think is going to happen moving forward? We obviously got a big election coming up. This is part of the platform we're talking about.

SHAPIRO: Well, these bills have been introduced in, oh, 30-something states. They've typically failed. In Mississippi, just a few months ago, a bill like this one as a referendum and it looked like it was going to pass. But when the medical community came in to educate a very conservative population, the people of Mississippi overwhelmingly rejected a personhood bill. They basically said this is bad for our health care. We don't want to do this.

GUPTA: So this is end the IVF over your right shoulder, you think that that -- I mean, you don't foresee that happening any time soon?

SHAPIRO: I don't think -- I don't think that's going to happen, but I'm a little bit dismayed that the folks who are trying to find a wedge against Roe v. Wade are using this particular approach, because it walks right over the backs of about one in eight American couples. That's how many people are infertile in this country. So we're not talking about a small number of people. We are talking about hundreds of thousands of people who seek care in the United States for fertility concerns. And these bills interfere with their ability to get good care.

GUPTA: Well, I appreciate you educating us on this. Obviously, again, as I said, it's a talker, a lot of people curious about this and something to say. Dr. Shapiro, hopefully, you'll join us again sometime.

SHAPIRO: Thank you very much for having me.

GUPTA: Thanks for having me.

And up next, the number one killer of women in this country, heart disease. I want you to know the symptoms, know the signs. It could save your life, perhaps the life of someone you love.

Stay with us.

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: Where are your shoes? Put your shoes back on, please? Go help your sister.

We are going in three minutes. Oh, my God, what am I doing? I forgot to cut of the crust. Voila! Shoes on, potty if you need it. And get your sister.

OK, here. Nobody move! I'm getting a dust pan.

UNIDENTIFIED KID: Mom, I think you're having a heart attack.

UNIDENTIFIED FEMALE: Honey, do I look like the type of person who has a heart attack?

(END VIDEO CLIP)

GUPTA: That was a clip from the very funny short film called "Just A Little Heart Attack" starring and directed by Elizabeth Banks, produced for the American Heart Association.

It's part of the Go Red for Women Campaign. I have to tell you, it struck a chord because a lot of people paying attention to this issue in part because Rosie O'Donnell that she at age 50 suffered a nearly fatal heart attack just earlier this month.

She posted a poem on her blog. That's how she let people know about it. It reads, in part, "My LAD," which means the left anterior descending artery on the heart, "was 99 percent blocked. They call this type of heart attack the widow maker. I'm lucky to be here. Know the symptoms, ladies, and listen to the voice inside. The one we so easily ignore. Call 911."

And you wouldn't believe how many people don't call 911. Even Rosie didn't. She reprimanded herself for this and she didn't visit the emergency room, really visit her cardiologist until the next day. Lucky for her she's OK.

But as you might guess, not all women are so lucky. We beat the drum on this issue a lot.

And joining me to talk about it is Dr. Suzanne Steinbaum. She's a cardiologist at Lenox Hill Hospital in New York City and has been involved with beating the drum on this issue for a long time as well.

Thanks for joining us, Dr. Steinbaum.

You know, one of these things Rosie talked about was that she missed the signs. And it seems that everyone generally knows the symptoms for a heart attack in men, but with women, it can be different. How do you educate your patients about this?

DR. SUZANNE STEINBAUM, CARDIOLOGIST, LENOX HILL HOSPITAL: Well, what I say is it's not necessarily that typical Hollywood heart attack of a man clutching his chest. In fact, in women, the signs are often more subtle. There could be shortness of breath, nausea, vomiting, back pain, jaw pain. And in fact, Rosie wasn't sure it was her heart because it was not in that location.

What I will always tell my women patient is if you are doing your daily activities and suddenly, it becomes more difficult, suddenly you feel like you just can't do the same things, whether it's due to shortness of breath or even flu-like symptoms, then you must consider that it might be your heart.

GUPTA: So that's an important point. If you have some of these new symptoms in Rosie's case, she talked about the fact that she felt clammy, her skin felt clammy, she was nauseated, but if it comes on suddenly, it seems to be a red flag. How do you know, Dr. Steinbaum when it's serious enough to call 911? Because a lot of people think that's a big step to simply make that phone call.

STEINBAUM: I think there is such a thing as women's intuition. And, really, when I talk to all my patients and like Rosie said, she had a feeling it was her heart. If you really have a sense that you cannot breathe, that the pain is getting worse, I'd rather you call and be wrong than not call and have a heart attack.

GUPTA: Let me show you, actually, we'll show you how that exactly played now the short film. Take a look.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: Hi, sorry to bother you. I think I might be having a little heart attack. Nothing really, just some nausea, tightening of the jaw, dizziness, shortness of breathe, muscle pain, achiness, a terrible pressure in my chest.

Oh, really? They can be here in how long? Two minutes? Can you make it 10?

(END VIDEO CLIP)

GUPTA: She literally started that with, sorry to bother you as she's calling 911 -- almost the fear of embarrassment. But does that clip ring true? I mean, the American Heart Association to your point says only half of women say they would call 911 if they experienced heart attack symptoms, but they also go on to say that more than three quarters would call 911 if it was somebody else having a heart attack. What -- why is that?

STEINBAUM: It's amazing. As women we tend to put ourselves last. We don't want to put anyone out. We don't want to be wrong. We are afraid we'll make people take care of us and it actually won't be our heart.

In fact, in one study when women were asked, "Why wouldn't you call 911," they said they would do the dishes in the sink first. There are so many reasons why a woman might not call, but women tend to put themselves last. And like you say, they will do it for someone else before they would do it for themselves.

GUPTA: I know. And, it's amazing because women typically are the health care drivers in families, but they sometimes forget about it for themselves. If you've called 911, what should you do next? Are there things you can be doing at home even those few minutes while you're waiting?

STEINBAUM: I think Rosie did exactly what every woman should know about, take two aspirin, pop them into your mouth and chew them. Call 911. And if you're wrong, it doesn't matter because you might just save yourself. You might save your life.

GUPTA: Again, very important advice. You take that aspirin to make your blood a little thinner, you chew it so it absorbs more quickly, hopefully people are listening and this will make a difference.

Dr. Steinbaum, thanks so much for joining us.

STEINBAUM: Thanks so much for having me.

GUPTA: Endurance swimmer Diana Nyad extreme dream was cut short yet again. Thirty-five years in the making. I'm going to talk to Diana about what went right, what went wrong on her fourth and probably final attempt to swim from Cuba to Key West. Stay with us.

(COMMERCIAL BREAK)

GUPTA: Every once in a while, you meet something that fundamentally paints the world around you. And for me, Diana Nyad is one of these people.

At 60 years old, she decided to take on a challenge that seemed nearly impossible for someone half her age. But she didn't complete the swim, her fourth attempt from Cuba to Key West.

But I can't help but think the journey is far more important than the destination.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): A hundred three miles lay between Havana, Cuba, and Key West, Florida. The sea is rough here, the currents are swift. And this stretch of ocean is home to nearly a dozen species of sharks and jellyfish. Simply boating across these waters is tough, swimming it nearly impossible. But one woman, marathon swimmer Diana Nyad, set her sights on that goal over 30 years ago.

In 1978, she swam 41 miles from Cuba. A year later, she made it 89 miles from the Bahamas to Florida -- a world record. And then she quit swimming.

DIANA NYAD, ENDURANCE SWIMMER: I thought to myself, I will never swim another stroke in my life.

GUPTA: That is until she turned 60.

NYAD: I was driving in my car last year telling myself, you better get with these life lessons. You better just seize the day. I was looking at the cars in the rear-view mirror and caught a sought of my eyes for a second and thought, but wait a second! Maybe I could go back.

GUPTA: She got back in the water slowly at first, and then put herself through the first big test.

NYAD: I did a 6 1/2-hour swim. That's the day I knew this summer I'm swimming from Cuba to Florida.

GUPTA: She trained for hundreds of hours, getting ready to take on what she called the extreme dream. But delayed Cuban visas and bad weather forced her to put that dream on hold. 2011 she got her shot.

On August 7th, a ceremonial bugle performance and she was off. But the rest didn't go as planned -- an aching shoulder, an asthma attack.

NYAD: I'm just dead, I'm dead.

GUPTA: She got out of the water after 29 hours.

Just a month later a very different scene. On September 24th, she dove back in for attempt number three. This time it was stings from box jellyfish. They took her out after more than a day of swimming.

NYAD: Never, ever in my life have I had pain like that.

GUPTA: But Diana could not let the dream go. 2012, she jumped in again at the Marina in Cuba, attempt number four. The first several hours went smooth and then jellyfish stings again. But this time she was armed with a special suit, thunderstorms knocked her off course, but she got back on. After almost 42 hours of swimming and 63 hours after leaving Havana, another storm so dangerous the lightning could have killed her. By sunrise on day four, Diana came out of the water for the last time.

I called Diana as she rested on the boat heading back to Key West.

(on camera): Hey, it's Sanjay.

NYAD: Sanjay, how are you, good brother?

GUPTA: I'm doing all right, Diana. How are you doing?

NYAD: Physically, I was ready to pain (ph). I was ready to just every possible aspect. It is just a huge part of Mother Nature right here. There are so many variables that, I don't know, Sanjay, I thought I would make it across one day, and I have some luck. But I think it's going to be a certain series of circumstances to put together more extensive (ph) three days.

GUPTA (voice-over): This time it seems the extreme dream is over for good.

Surrounded by her team of divers and handlers, Diana did a ceremonial walk up onto the Florida shores, a picturesque end to a remarkable journey.

(END VIDEOTAPE)

GUPTA: Well, it looks like this really was her last shot. But as we have seen, you never know what the future might hold, especially when it comes to Diana Nyad. I'm really glad to call her a friend.

If you're watching, Diana, thanks so much.

And coming up, chasing life, one thing you want to make sure you stick in your suitcase whenever you travel.

(COMMERCIAL BREAK) GUPTA: Well, today we have a "Made in America" success story. As a child, Ralph Braun was told he wouldn't live past his teen years, but he defied those odds as you might guess, and the company in his hometown now has clients all over the world.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Each day, you'll find Ralph Braun at the headquarters of the company he founded in the 1970s, the Braun Corporation. He's been in business for 40 years and he has clients around the globe. But such a successful future seemed unlikely when he was diagnosed with muscular dystrophy in 1946.

RALPH BRAUN, FOUNDER, BRAUN CORPORATION: My parents were told that I would probably not live past my teens.

GUPTA: Braun grew up in rural Winamac, Indiana. He says back then, there were no sidewalks. People like Braun were not welcome.

BRAUN: Disabled people were looked at in the '40s and early '50s and whatever as is most of the time they should be just sitting in a closet somewhere.

GUPTA: His way of becoming successful was born out of necessity. By that time, Braun was unable to walk. But he needed to be able to get to and from work. So he tapped his love of engineering. Cobbled together random parts and created a scooter so he could get on the road. The year was 1963.

BRAUN: The three-wheel scooters that you see today in the supermarkets and wherever were -- there wasn't any such thing. And so I built the first one, a four-wheeler, which you know, I call Frankenstein. And then I brought -- I built the second one, which was the three-wheeler, and which was the bride of.

GUPTA: Today, his company manufactures several thousand wheelchair accessible vehicles and lifts every year. Braun is improving the lives of many people just like him all over the world.

(END VIDEOTAPE)

GUPTA: Chasing life today, keeping you safe away from home. You know, I traveled quite a bit and sometimes I go to countries where I don't know how to speak the language. As a doctor, I like to be prepared and want to offer that to you as well.

So I found this little guide book that caught my eye called "The Visual Language Translator". It's a medical book made by a company called Quick Point.

I want to show you how it works. You open it up and literally point to what's bothering you. We have an example over here.

Take a look. Let's say you go to the hospital and are trying to explain that you had a peanut allergy. Over here is the allergy section. This is what somebody might look like who's suffering from allergies and you can point specifically to the peanuts. That's a very hard thing to convey without a good book like this.

Let me give you another example as well. Let's say you've been somewhere where you've actually had a bite. We'll show how a bite looks like this and even point to specifically what caused the bite -- maybe a spider bite. You can point to that.

Or even as we talked about earlier in the show, one of the biggest killers anywhere in the United States is heart disease, but if you're in a foreign country trying to explain this, say it specifically, you know, the guy is pointing to his heart and shows somebody who is having a heart attack. And this could actually potentially save you a lot of trouble, if not your life.

They sell a few different versions like this. The one I'm holding up here is the most expensive, about $16. But again, it might be worth it if it saves you a lot of medical trouble.

Well, that's going to wrap things up for SGMD today. But stay connected with me at CNN.com/Sanjay. Let's get that conversation going on Twitter as well, @SanjayGuptaCNN.

Up next, though, a check of your top stories making news right now.

(COMMERCIAL BREAK)